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Abstract: Consider the case of Pete. Pete sets the table while his wife Lucie is cooking. Lucie says to Pete, “Let’s not use these plates. Let’s use the beige set instead.” Upon hearing this seemingly innocuous suggestion, Pete explodes and tells Lucie that she does not value him or his efforts.1 Suppose further that, with Pete, this is a pattern. Sometimes, he flies into a rage in this way, seemingly for no reason, to the detriment of his social and personal life. What is Pete to do about this' There is a view widely prevalent in philosophy on which Pete needs to identify the undesirable elements in his own mental economy and subdue and, if possible, even extrude them. If he successfully accomplishes this, he will become a ... Read More PubDate: 2023-09-30T00:00:00-05:00
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Abstract: I thoroughly enjoyed reading and reflecting on this provocative, engagingly written, and persuasively argued paper. My commentary focuses on the authors’ “understanding first” principle. I begin by exploring that principle’s scope by appeal to aesthetic analogues to the moral cases of Pete and Jacob; I then explore its limits by appeal to cases involving agents struggling with maladaptive traits that are more self-destructive than antisocial.According to the authors, when attempting to eliminate or reduce a maladaptive trait, it is important that the agent begin with a non-moralizing understanding of that trait’s “root cause.” In this way, the agent avoids some of the epistemically distorting and otherwise ... Read More PubDate: 2023-09-30T00:00:00-05:00
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Abstract: I am in general agreement with the authors that a psychoanalytic or psychodynamic approach is a good response to simple pruning procedures. That said, however, I do have questions about how they develop their argument.I was surprised at the very notion of pruning, and quite surprised that it is as popular as the authors suggest. The idea that Pete should deal with his inappropriate outbursts by erasing or pruning that aspect of his personality seems so ridiculous that it beggars belief. It leaves one wondering whether Pete, or anyone agreeing with this argument, is credulous enough to think you can just prune away an undesirable part of yourself.The authors write:Importantly, this expulsion is often thought to be a ... Read More PubDate: 2023-09-30T00:00:00-05:00
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Abstract: We would like to thank the editors for organizing this symposium and our commentators—Marga Reimer and James Phillips—for the thought-provoking feedback. Although we had thought about the ideas we discuss from many different angles, our commentators raised several interesting issues we had not considered. We are grateful for the opportunity to continue the conversation.As Professor Reimer notes, we advocate an approach to self-constitution that we dub “understanding first.” On this approach, non-moral and non-normative understanding of the origin of maladaptive traits must precede moral evaluation and attempts to free oneself—or as we say “prune”—undesirable traits. Professor Reimer presents several interesting ... Read More PubDate: 2023-09-30T00:00:00-05:00
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Abstract: In 1914, Jacob Levy Moreno published a text on the concept of “encounter,” a fundamental notion that runs through his work. According to him, it is a central process to group psychotherapy and even more to group psychodrama. It describes a feeling that is shared, a being-together. About this concept, Moreno (1987, p. 128) wrote:In the beginning was the action, but an action is not possible without an actor, without an object— that is the goal of the actor—and without a ‘You’ to meet. In the beginning was the encounter: you are here with me and I want to tear your eyes out from your sockets and put them in the place of mine, so you can tear mine and put them in the place of yours and see me with my own eyes. At the ... Read More PubDate: 2023-09-30T00:00:00-05:00
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Abstract: I have enjoyed reflecting on Mr. Chapy’s account of work in psychodrama with a patient with schizophrenia.Although at one time many years ago I was interested in phenomenological psychiatry, and especially the writings of Ludwig Binswanger and Medard Boss, I am not an authority on dasein-analysis, so I have nothing to add to the discussion. I should say, however, that my father had little interest in this approach, which was far too abstract for his taste. He proceeded from the standpoint of the theater, of action and enactment. He believed that the drama itself provided the insight.For the purposes of this response, I take it as a given that the patient in question has been accurately diagnosed, although in the ... Read More PubDate: 2023-09-30T00:00:00-05:00
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Abstract: As a long-time student, practitioner, trainer, author and advocate of J. L. Moreno, MD,’s works and specifically the psychodramatic method, I am always appreciative of efforts, like Chapy’s, to commend and advocate for psychodrama. This is especially so because for a time, Moreno and psychodrama were heavily criticized, even maligned in the mental health professions. At the same time, considering how poorly Moreno and his methods have been understood as well as the difficulty of accessing his original material, I feel an obligation to set the record straight when confronted with incomplete, inadequate, or sometimes incompetent expositions of Moreno’s psychodrama.Chapy’s article recommends psychodrama as a treatment ... Read More PubDate: 2023-09-30T00:00:00-05:00
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Abstract: Thank you for the honor of taking the time to comment on the work we do. It is very meaningful for us to be able to talk with you.We, too, see a big difference between philosophers and carers (in the broadest sense) who deal with the suffering of patients and try to find methods to help them. But, if theory is at the service of the clinic, it becomes a formidable asset to refine our therapeutic methods and better understand what is happening to our patients.Indeed, patients suffering from psychosis, severe neurosis … are difficult to accompany and “recalcitrant to therapy by word alone” to use your terms. It is on this point that Ludwig Binswanger distanced himself from psychoanalysis. Binswanger ran a sanatorium ... Read More PubDate: 2023-09-30T00:00:00-05:00
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Abstract: According to an orthodox definition contemporary psychiatric assessment is based on two types of instruments: diagnostic scales (or diagnostic criteria) and rating scales (Rush, Frist, & Blacker, 2007). The former, inherited from the classificatory tradition in psychiatry, are used to establish a diagnosis for a patient using a decision tree based on a list of symptoms whose presence is required, for some, and is more secondary, for others. Thus, according to the criteria chosen by the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 for a major depressive episode (American Psychiatric Association, 1980), the subject must have shown a sad mood during the 2 weeks preceding the consultation ... Read More PubDate: 2023-09-30T00:00:00-05:00
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Abstract: Le moigne narrates a history of the development of psychiatric ratings scales as hybrids between psychological tests and diagnostic categories. In his telling, psychological tests seek to quantify population-based traits on which every person has a position and which tend to be conceptualized as being stable. Personality traits are often conceptualized as dispositions. Diagnostic categories represent not trait-like properties of populations but episodic states consisting of clusters of symptoms experienced by individuals with disorders. Ratings, scales, he notes, are hybrids between the two. They are used to quantify psychiatric symptom clusters so that change over time can be measured. Le Moigne argues that these ... Read More PubDate: 2023-09-30T00:00:00-05:00
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Abstract: Depression is a complex mental health phenomenon due to its multifaceted nature. For one, depression is thought to have a significant genetic component, with studies suggesting that heritability is a significant factor in the development of the disorder (Sullivan, Neale, Kendler, 2000). In clinical psychology, environmental factors such as childhood trauma, chronic stress, social isolation and negative life events (e.g., the loss of a loved one) have been documented as significant risk factors for the development of depression or as trigger events for depressive episodes (Fu & Parahoo, 2009; Kendler, Kuhn, & Prescott, 2004; Neitzke, 2016). Despite this, causal theories of mental health conditions are often tricky ... Read More PubDate: 2023-09-30T00:00:00-05:00
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Abstract: As Peter Zachar rightly points out in his comment, the assessment of mental disorders underwent new developments with the release of the Diagnostic and Statistical Manual of Mental Disorders-V in 2013 (American Psychiatric Association, 2013). Whereas in 1980, the manual had been thought of in a rigorously categorical way, on the basis of distinct and closed syndromic entities, this new version advocated the development of a radically dimensionalist approach, with the diagnosis aiming this time to restore the whole symptomatological picture of the patient on a spectrum of ratings are supposed to cover the entirety of psychiatric semiology (American Psychiatric Association, 2013).For its part, my article aimed to ... Read More PubDate: 2023-09-30T00:00:00-05:00
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Abstract: Just as the rings made on the water by raindrops are first small and distinct and then grow larger and larger, swallow each other and vanish, so from time to time in psychiatry there emerge diseases which constantly enlarge themselves until they perish with their own magnitude.We come to see ourselves differently as we catch sight of our images in the mirror of the machine.The responsibility absorbed by psychiatry to define the border of mental health and illness has been termed the “boundary problem” (Bolton, 2013). Diagnosis, among other competing functions, interacts with the boundary problem to signify that an individual’s condition constitutes a “case.” That is, the individual falls on the side of the ... Read More PubDate: 2023-09-30T00:00:00-05:00
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Abstract: Saunders explores challenges for the clinician faced with self-styled sufferers from attention deficit hyperactivity disorder, post-traumatic stress disorder, bipolar disorder, autism spectrum disorder (ASD), and fibromyalgia. The diagnostic system was not meant to be used as “a scaffold for identity,” she points out. Yet wannabe patients now step into the clinic wielding self-proclaimed diagnoses as social identities. Saunders explains the context where such phenomena arise, and offers guidelines for clinicians addressing this new reality. To do so, she enlists Rashed’s innovative normative approach to the so-called boundary problem of assigning, and providing justification for, the contested line between normal ... Read More PubDate: 2023-09-30T00:00:00-05:00
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Abstract: Linda A.W. Brakel is an Adjunct Associate Professor of Psychiatry and an Adjunct Faculty Research Associate in Philosophy at the University of Michigan. She has practiced psychoanalysis for more than 40 years. Her published work is largely interdisciplinary, centering on psychoanalytic theory with respect to philosophy of action, and philosophy of mind. She is the author of Philosophy, Psychology and the A-Rational Mind (Oxford), Unconscious Knowing (Oxford), The Ontology of Psychology (Routledge), and Investigating the Trans Self and Moore’s Paradox (Palgrave-Macmillan).Alexandre Chapy is a clinical psychologist who works as a temporary lecturer in the Master of Clinical Psychology: “Clinical phenomenology of ... Read More PubDate: 2023-09-30T00:00:00-05:00
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